Pain, co-contraction and Botox

[Sarah]

I could really use some advice...

My daughter Emma is 9 now and has recently started having pain in her affected shoulder and arm (inside elbow mostly). She has good ROM, but cannot straighten her arm completely and is somewhat internally rotated. She continues to have regular PT to help lessen the tightness in her arm.

Emma is a very active kid - swims like a fish and plays hockey. She generally complains of pain after playing sports and when she does a lot of writing at school.

Her doctor (Bain @ McMaster) believes that the pain is caused by muscle co-contraction and is 'normal' for Emma based on her physiology. He has suggested Botox to help with the co-contraction and pain, and splinting (at night) for the elbow contraction. This is our first experience with Botox so I'm not sure what to expect. I've been reading other posts and find the results described to be encouraging.

My biggest concern is how her arm will work after the treatment. Like will she be able to do all the same things she can do now? I'm scared to death of her losing something. I understand that she will have some weakness as her muscles 're-learn' but I don't really understand what that will mean for her physically. For example, how will it feel when she shoots the puck or swims? Also, since our main goal with this treatment is to alleviate her pain, is this the best choice for her?

Thoughts, opinions and comments would be greatly appreciated!

Thank you,
Sarah

[claudia]

We used Botox on Juliana both along time ago and more recently, after a surgery. We were very pleased with the results. I also wondered about what she would lose. I wondered if she would have this floppy arm as the weaker muscles were asked to work.

However, that isn't what happened. Yes, there was some weakness, but maybe it's because they learn to compensate so well, but she didn't seem to be bothered.

I think it is worth a go. Especially if she is physically active. Juliana is 11 1/2 now and also very active. She too has pain in her shoulder after sports (she is primarily a tennis player), but generally lives with pain all the time.

I have been a long time believer in botox.

claudia

[Sarah]

Thanks Claudia. It's good to hear first-hand from another parent.